Report of a case of latrodectism occurring in Manaus, Amazonas, Brazil

In July 2, 1995 arrived at the Instituto de Medicina Tropical do Amazonas as eleven-year-old male with complaining of spider bite on his right retroauricular region, presenting typical findings of latrodectism. The accident was reported as having occurred in the suburbs of Manaus. The patient was given neostigmine preceded by atropine, calcium gluconate, cimetidine, diazepan and hydrocortisone. Within three days the patient showed improvement, and was aware, orientated and with significant palpebral oedema reduction. Muscle spasms are still present, as well as fever, shivering, and intense sweating. In spite of a daily progressive improvement, at the fifth day appeared a spotted papular erythema. The patient was discharged without symptoms after the 13th day. This is the first such reported case which took place in Amazonian region, it might have been happened a consequence of the urban sprawl which has characterized the growth of the city of Manaus, in the last twenty years. It is not possible at this point to evaluate the epidemiological resound of the event, but in any case, it seems plausible to recommend that black widow antivenom become available.